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Objective To analyze the relationship between renal pathological characteristics and clinical prognosis in type 2 diabetic kidney disease patients,and discuss predictive value of pathological type and indexes for renal function declining rate and related outcome events.Methods Ninety-two type 2 diabetes patients from PUMC Hospital (with macroalbuminuria and followed up no less than 6 months,excluding patients with non-diabetic renal disease) were divided into typical diabetic glomerulopathy group (DG,n=51) and atypical diabetes-related renal disease group(ADRD,n=41) according to renal pathological findings.A retrospective cohort study was performed to investigate renal pathological features and prognosis.Results Total of 29 renal outcome events and 12 death events occurred in DG group and none in ADRD group; the survival rate and kidney survival rate are different between two groups (P ＜ 0.05); DG group,thick GBM,severe vascular and tubular lesion are predicative indicators for renal outcome event; mesangial volume fraction is predicative indicator for renal outcome events independent of age and serum creatinine.Conclusions DG and ADRD patients have different prognosis and might undergo different pathophysiological mechanisms; renal pathological type and mesangial volume fraction could help predicting outcomes of type 2 diabetic nephropathy patients.
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Objective To analyze cases diagnosed with glomerular minor lesion (GML) by light microscopy and immunofluorescence,uncover their final pathology diagnosis by electron microscopy,and thereby clarify the pathological and clinical meaning of GML.Methods One hundred and forty-eight patients receiving renal biopsy between 2003 and 2008 in Peking Union Medical College Hospital,with diagnosis of GML described by light microscopy and immunofluorescence examination were retrospectively studied.All the clinical data and pathological observation were collected and analyzed,including intact results of electron microscopic examination which were considered as golden standards of pathological diagnosis.Results The 148 patients with GML had heterogenous clinical features,with isolated hematuria as the most common presentation.Electron microscopy revealed various pathological presentations:thin basement membrane nephropathy (TBMN,66.2％),mesangial proliferative glomerulonephritis (MsPGN,20.3％),Alport syndrome (2.7％),membranous nephropathy (MN,3.4％),normal tissue (4.7％).Among GML patients with isolated hematuria,TBMN ranked as the most common pathology (76.9％).Conclusions GML is only an equivocal description of pathological manifestation by light microscopy and immunofluorescence examination.And electron microscopy is necessary to obtain accurate pathology diagnosis for patients undergoing renal biopsies.
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Animal experiment is a primary part of medical education. At present , medical students are lack of education about laboratory animal ethics and they do not usually treat animals fol-lowing rules of laboratory animal ethics. To solve this problem, we focused on the education of labora-tory animal ethics and 3R theory (reduction, replacement, refinement) in order to help the medical students treat laboratory animals nicely. We enforced the construction of the laboratory rules and regu-lations, and improved animal experiments conditions. With these efforts, we successfully standardized and scientized our experiment classes.
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Nursing students in junior college have less class time and weaker foundation com-pared with nursing undergraduates, therefore it is more difficult for them to learn pathphysiology. In order to improve the teaching effect, we adopt the following strategies in pathophysiology teaching:①Guiding clinical nursing practice combining with specific situation in order to give students a deep understanding of pathophysiology knowledge and its significance. ②Urging students to review relevant basic knowledge before class and teacher to briefly introduce the basic knowledge before initiating class in order to reinforce the knowledge. ③Examples of daily life should be combined to make the abstract theory knowledge vivid. Teaching should revolve around the main line and key points should be highlighted. ④Dividing pathophysiology course into three units, and summary must be executed at the end of each unit.
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Proceeding from the requirements of teaching target for postgraduate students,the course of progress in pathophysiology was constructed and administrated.The course objective was defined which combined teaching knowledge with fostering students' ability together,especially the ability to think new ideas and to do scientific research.Aiming at this teaching target,the teaching contents which combined with the direction of scientific research of the department was growing together with scientific development,especially in new knowledge and new technique.Multiple teaching means and several mode of examine were adopted during the process of teaching practice.
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AIM: To study the protective effects of HIF-1α gene transfection on hypoxic injury in human HepG2 cells. METHODS: After gene transfection, HepG2 cells were randomly divided into 4 groups: normoxia with Ad-GFP transfected group, normoxia with Ad-HIF-1 transfected group, hypoxia with Ad-GFP transfected group and hypoxia with Ad-HIF-1 transfected group. LDH leaking rate, cell viability, contents of NO and ROS, the iNOS activity were measured. RESULTS: High levels of HIF-1α mRNA and protein were detected in Ad-HIF transfected HepG2 cells. Cell viability was significantly lower in Ad-GFP transfected-hypoxia group than that in Ad-GFP transfected-normoxia group (P<0.05). No marked difference of cell viability was found between Ad-HIF transfected-hypoxia group and Ad-HIF transfected-normoxia group. ROS was significantly higher in Ad-GFP transfected-hypoxia group than that in Ad-GFP transfected-normoxia group (P<0.05), while no marked difference was found either between Ad-HIF transfected-hypoxia group and Ad-HIF transfected-normoxia group or between Ad-HIF transfected-hypoxia group and Ad-GFP transfected-hypoxia group. The content of NO and iNOS activity were significantly higher in Ad-HIF transfected-normoxia group and Ad-GFP transfected-hypoxia group than those in Ad-GFP transfected-normoxia group (P<0.05), no marked difference was found either between Ad-HIF transfected-hypoxia group and Ad-GFP transfected-hypoxia group or between Ad-HIF transfected-hypoxia group and Ad-HIF transfected-normoxia group. CONCLUSION: Higher HIF-1α expression is contributed to protective effects against hypoxic injury in HepG2 cells, the mechanisms of which may be correlated with promoting expression of gene regulated by HIF-1 and restraining over-expression of injure factors.
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<p><b>BACKGROUND</b>The promyelocytic leukaemia (PML) protein has been implicated in control of key tumor-suppressive pathways. However, its role in pathogenesis of lung cancer is still unclear. The objective of this study is to assess expression and clinical significance of PML, P53 and P16INK4A in lung cancer, as well as the relation of these factors.</p><p><b>METHODS</b>The tissue microarrays were created with samples from lung cancers (n=148), pulmonary benign lung tumors (n=5) and normal lung tissues (n=7), and protein expression was analyzed by immunohistochemical staining. The association between protein expression and clinical parameters was evaluated by using Crosstabs method. The Kaplan-Meier method was used to estimate survival. Cox proportional hazards model was used for univariate and multivariate analysis.</p><p><b>RESULTS</b>There was at least triplicate 0.6-mm cores per sample, 4 cases of lung cancer were excluded for lacking of enough tissue. PML was found in the cytoplasm of 14.0% cases of NSCLC and of 39.1% SCLC (P=0.010), and in the nuclei of 31.4% NSCLC and 8.7% SCLC respectively (P=0.026). PML protein was present in 9 patients with SCLC and absent in 14 cases, 5-year cumulative survival rate of the patients was 50% and 23% respectively (Log-rank test, P=0.047). Lacking of PML protein and senior pathologic T-stage were two hazardous factors that influenced prognosis of SCLC. P53 expression was found in 33.3% lung cancer, and absent in benign tumors and normal tissues of the lung (P=0.038). P16INK4A expression was abolished in normal lung tissue, however, increased in lung cancer (28.5%), and especially in lung cancer with non- or poor differentiation (36.5%) and in SCLC (69.6%). There was inverse correlation between PML expression in the nuclei and P16INK4A expression, positive correlation between P53 and P16INK4A expressions in lung cancers. PML was negatively correlated with P53 in squamous cell carcinoma.</p><p><b>CONCLUSIONS</b>As an important suppressor of tumor, PML is related with P53 mutation in squamous cell carcinoma. Increased P16INK4A protein in lung cancer may be the results of gene mutation, and be related with mutant P53 protein.</p>
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In combination with the physiologic classroom instruction of high altitude pathophysiology,this text discusses ten kinds of heuristic teaching methods.These methods have certain functions of relaxing the atmosphere of the classroom,encouraging students'enthusiasm and helping to formulate their thinking ability.But we shoud grasp three principles in carrying out the heuristic education.First,the inspiration should have pertinency.Second,we should consider the accepting level of the students.Third,we should make best use of the situation and advance step by step.This article has certain directive significance to the classroom instruction.
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Objective To analyze the physiological factors related to acute mountain sickness(AMS) and establish a multiple line regression model to predict the AMS.Methods A total of 113 men aged(19?1) years were enrolled in this study.At 300 m above sea level,the pulmonary function by Vmax 229D spirometer,the physiological responses to hypoxia via breathing mixed gas(10% O_(2) and 90% N_(2)) for 10 min,the amount of urine at different time points after fast drinking 1 000 ml water,the responses of breath holding,serum cortisol by RIA,chest volume etc.were investigated.The symptomatic scores of benign form of AMS were calculated on day 2,3 after the subjects arrived at Lhasa(3 658 m above sea level).Multivariate linear regression analysis was used to check out the factors related to AMS.Results The chest volume,forced vital capacity,forced expiratory volume in 1 s,peak expiratory flow(PEF),the amount of urine within 1.5 h,2 h and 2.5 h after fast drinking 1 000 ml water,and the heart rate at 7~(th) min during breathing hypoxic gas were found related to AMS.The model of AMS prediction was as follow: scores of AMS=16.108-(0.003 04)?(the amount of urine within 2.5 h after drinking(1 000) ml water)-0.441?PEF-(0.048 7)?(the heart rate at 7~(th) min during breathing hypoxic gas)-0.240?chest volume.Of this equation,F=5.889(P
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AIM: To study the changes in capillarity of skeletal muscle during acclimation to high altitude, and explore the effects of a certain extent physical activity under hypoxia on capillary formation and the role of vascular endothelial growth factor (VEGF) in this process. METHODS: 48 Wistar rats were divided into 3 groups: Ⅰ normoxic control; Ⅱ hypoxia and Ⅲ hypoxia+exercise. Rats of Ⅱ and Ⅲ groups were subjected to hypobaric hypoxia for 5 weeks (23 h/d). They were first brought to simulated 4 000 m altitude, where rats of the Ⅲgroup were forced to swim for 1 h/d (6 d/week). Then the animals were ascent to 5 000 m. Biomicrosphere method was used to determine blood flow of skeletal muscle. The mean fiber cross-sectional area (FCSA), capillary density (CD) and capillary/fiber ratio (C/F) of red portion of the lateral head of the gastrocneminus were assayed by myofibrillar ATPase histochemistry. VEGF and its receptor KDR were assayed with immunohistochemistry method.RESULTS: By comparison with the normoxic control, 5-week hypoxic exposure resulted in a decrease in cross-sectional area of skeletal muscle fiber and an increase in CD, but the C/F remained unchanged. The blood supply to the gastrocnemius was not changed. After 5-week-exercise at high altitude, the muscle fibers did not undergo atrophy. CD, C/F, and the blood flow at rest increased significantly. VEGF protein was found primarily in the matrix between muscle fibers; KDR were shown mainly in endothelial cells of capillary. VEGF was more strongly stained in the skeletal muscle of hypoxia-exercise rats.CONCLUSION: Hypoxia itself can not induce neovascularization. While exercise during hypoxic exposure can lead to capillary formation. VEGF and KDR may play roles in it. New capillary formation benefits the blood supply, oxygen delivery and working performance at high altitude.
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Objective To determine the expression and the change of vascular endothelial growth factor(VEGF) and it's acceptor Flt-1 during maxillofacial blast injury at early stage,and to evaluate the effect of VEGF on traumatic wound healing.Methods The rabbit model of maxillofacial blast injury was made by KTY-04 blasting cap. The expression of VEGF and Flt-1 in wound tissue was determined by ABC immunohistochemistry after injury 6h,1d,2d,3d,5d,and 7d. Also,the results were compared with preinjury groups.Results In the wound tissue of maxillofacial blast injury, the expression of VEGF was rising steadily at the first week after injury. Comparing with normal tissue,it showed different from the first day after injury, and showed very different from the third day(P<0.01).It reached the peak at the seventh day after injury.The expression of Flt-1 showed no difference within 3 days after injury comparing with normal tissue.After injury 5d-7d,the protein expressed strengthly.Conclusion The stage of the VEGF expression at maxillofacial blast injury is similar to the angiogenic stage during wound healing, and the Flt-1 expression is also occurring at that period.It illustrates that VEGF take part in angiogenic cascades of traumatic wound healing and product auxo-action to the regeneration of blood vessel.
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AIM: To study the changes in myocardial blood flow (MBF), capillarization and cardiac function in the rat during acclimation to hypoxia. METHODS: Myocardial capillary density (CD) and capillary/myocyte ratio (C/M) was assayed by alkaline phosphatase histochemistry. Biomicrosphere method was used to determine MBF in the rat after 5, 15 or 30 days hypobaric hypoxic exposure (5 000 m). RESULTS: In the course of hypoxia, MBF and cardiac function increased in the right ventricle. However, in the left ventricle, acute hypoxia caused an increase in MBF and a decrease in cardiac function. Both returned to the control level on continued hypoxic exposure. Neovascularization occurred after 15 day or 30 day of hypoxic exposure in both ventricles, judged from the significant increment of C/M ratio albeit the CD remained unchanged in the right ventricle. CONCLUSION: Our findings indicate that adaptive changes in rat heart during acclimation to hypoxia include: ① persistent increase in MBF, hypertrophy associated with increase in capillarity and enhanced cardiac function of the right ventricle; ② increase in MBF and depression of cardiac function at first, then followed by recovery of MBF and increase in capillarity accompanied with recovery of left ventricular function.
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Purpose: To study the clinical efficacy, toxicity of preoperative chemotherapy and survival time with Gemicitabine-Cisplatin combination in the treatment of stage Ma( N2) NSCLC. Methods: Thirty patients with stage IIIa( N2) NSCLC were included. Gemicitabine was administered on dl, 8 and 15 at a dose of 1000 mg/m" and Cisplatin at a dose of 100 mg/m on d2. The chemotherapy was repeated every 28days. Results: Thirty patients were evaluable for response. The overall response rate was 70%. Surgical'excision rate after preoperative chemotherapy was 93%. Total surgical excision rate was 70%. Median survival time was 15 months, one year survival rate was 67%. The main toxicity was hematological, thrombocytopenia of grade III-IV appeared in 46% course of treatment, but it did not lead to hemorrhage. Conclusions: Preoperative chemotherapy with Gemicitabine-Cisplatin combination is effective and well-tolerated in the treatment of stage IIIIa( N2) NSCLC. So it is worthy to be further studied and popularized.